Wed. Jan 9, 2019 from 12-1pm EDT. Join Lianne Singer, University Health Network as she discusses the recnt trend of transplant programs accepting older donors and recipients with more chronic health problems.  She investigates the possibility that some of these patients are frail which results in poor outcomes after transplantation. She discusses a study to develop and test the usefulness of a new tool to measure frailty in donors and candidates for heart, lung, kidney or liver transplantation. To learn or to register click here.

Highlights of this issue include the featured topic of Liver Health Considerations for the Older Adult, updates regarding Age-Friendly Communities. Advance Care Planning and Health Care Consent Education, Regional Integrated Falls Prevention and Management Strategy and a listing of upcoming events. Sign up to receive Linkages directly here.

This reading list provides links to and summaries of a variety of open source resources related to the older adult and liver health considerations.  3 pages..

This Canadian Liver Foundation webpage provides links to a variety of diagnostic tools and calculators such as LiverTox, Model for End-Stage Liver Disease Score (MELD Score), Maddrey’s Discriminant Function for Alcoholic Hepatitis and the Reach-B Score.

In this review the authors describe the epidemiology, mechanisms, detection and management of drug-induced liver injury with particular concern to old age. They argue that monitoring for clinical response is essential to optimize efficacy and reduce toxicity. They warn that the detection of adverse effects of medications in older patients can be complicated by nonspecific presentation as geriatric syndromes.

According to current conventional practice 80% to 90% of hepatic injuries can be safely managed without operation. (2) Previously conservative management of the hepatic injuries were recommended for hemodynamically stable patients who did not require blood transfusion and number of trauma centres strongly recommended conservative strategy in alert patient who are able to cooperate with physical examination.

This review addresses three questions pertaining to liver transplantation of the elderly: (1) Is liver transplantation in the elderly feasible? (2) How to select elderly patients who have a realistic chance of long-term survival and high quality of life after transplantation? (3) How to improve medical management of elderly patients who have undergone liver transplantation?

These Clinical Practice Guidelines (CPGs) have been developed by a panel of experts chosen by the EASL and ALEH Governing Boards. The CPGs were established using data from PubMed and Cochrane database searches. The strength of the recommendations reflects the quality of the underlying evidence.

These guidelines are largely based on the issues raised during the European Association for the Study of Liver monothematic conference on Alcoholic Liver Disease in 2010. The guidelines have three main aims: (1) to provide physicians with clinical recommendations; (2) to emphasize the fact that alcohol can cause several liver diseases (steatosis, steatohepatitis, cirrhosis), all of which may coexist in the same patient; (3) to identify areas of interest for future research, including clinical trials.

The mission of this association is to advance and disseminate the science and practice of hepatology, and to promote liver health and quality patient care.